摘要
目的探讨超声引导下腰丛联合坐骨神经阻滞在老年单侧关节置换术中的临床效果。方法选择2013年1月至2014年12月开封市中心医院收治的行老年单侧关节置换术患者100例,随机分为观察组和对照组各50例,对照组给予腰硬联合麻醉,观察组给予超声引导下腰丛联合坐骨神经阻滞。比较两组患者术中不同时间段血压、心率(HR)、血氧饱和度(SpO_2)变化情况以及麻醉起效时间、维持时间和围术期血清S100β蛋白水平变化情况。结果观察组麻醉后10min(T_3)、20min(T_4)、30min(T_5)时间点HR、平均动脉压(MAP)均高于对照组(P<0.05);观察组感觉神经阻滞、运动神经阻滞维持时间均高于对照组(P<0.05);观察组手术进行2h(T_b)、手术结束时(T_c)、术后2h(T_d)、术后24h(T_e)血清S100β蛋白水平均低于对照组(P<0.05)。结论老年单侧膝关节置换术中行超声引导下腰丛联合坐骨神经阻滞,可有效维持患者术中血流动力学稳定,延长镇痛时间,降低血清S100β蛋白水平,值得临床推广应用。
Objective To investigate the anesthetic effect of ultrasound guided lumbar plexus combined sciatic nerve block in the elderly in knee arthroplasty.Methods From January 2014 to December 2013,100 patients with knee replacement surgery were selected as the research objects,which were randomly divided into observation group and control group,each of 50 cases.The control group was given combined spinal and epidural anesthesia,the observation group received lumbar plexus and sciatic nerve block guided by ultrasound.Blood pressure,heart rate,respiratory rate,oxygen saturation changes and the changes of serum S100β levels were compared between the two groups.Results The observation group T3,T4,T5 HR and MAP were higher than that in the control group（P〈0.05）.The sensory nerve block and motor nerve block were higher in the observation group than that in the control group（P〈0.05）.The observation group Tb,Td,Tcand Teserum S100β levels in were lower than those in the control group（P〈0.05）.Conclusion For elderly patients with single knee joint replacement,intraoperative ultrasound guided lumbar plexus and sciatic nerve block can maintain the flow mechanical stability,prolong the duration of analgesia,decreased the level of serum S100β protein,and it is worthy of application.
作者
刘芳芳
张梦丽
王成钢
郭秋红
LIU Fang-fang;ZHANG Meng-li;WANG Cheng-gang;GUO Qiu-hong;(Department of orthopedics,The Second People’s Hospital The Central Hospital of Kaifeng of Henan province)
出处
《青岛医药卫生》
2018年第2期81-84,共4页
Qingdao Medical Journal
关键词
膝关节置换术
老年患者
腰丛联合坐骨神经阻滞
麻醉效果
Knee arthroplasty
Elderly patients
Lumbar plexus combined sciatic nerve block
Anesthetic effect
